Month: October 2022

A patient injured in more than two body systems is defined as multiply injured.This situation commonly occurs in road traffic accidents, falls from a height, blast injuries, etc. The approach to a patient with multiple injuries has to be systematic in order to identify all the injuries and prioritize their sequence of attention. Resuscitation Required […]

The majority of burns are caused by heat, which may be open flame, contact heat, and hot liquids (scalds). Others are chemical, electric, friction, sunburns,and irradiation.NB: Extreme cold can cause tissue injuries(i.e frostbite).   Initial Management of Burn Cases FIRST AID MEASURES If not acted upon at lower level, initiate the following management plan: Airway: […]

These include bites by humans, dogs, and other domestic animals, as well as wild animal bites.   Management This will depend on the extent of tissue loss and the site of injury. Most bites consist of cuts and simple lacerations. Other animals(hippopotamus, and crocodiles)inflict major tissue destruction(lacerations, avulsions, and amputations). Immediate Care If not already […]

Injuries to the spleen, liver, bladder, gut, etc., are not an uncommon cause of preventable death and their proper clinical assessment is vital. The spleen,liver, retroperitoneum, small bowel, kidneys, bladder, collorectum, diaphragm, and pancreas tend to be the most commonly injured organs. Signs and Symptoms of Blunt Injuries Abdominal injuries can be masked by injuries […]

The aims of postoperative care are to: Monitor the patient’s postoperative period to detect and correct any anomalies. Keep the patient comfortable and give adequate analagesia. Rectal diclofenac 100 mg(adults), paracetamol for children or pethidine 1 mg/kg TDS. Offer supportive feeding. Restore normal health and independence.   IMPORTANT: To achieve the above, the surgeon must […]

Antimicrobial prophylaxis can decrease the incidence of infection, particularly wound infection after certain operation, but this benefit must be weighed against cost, risks of toxic or allergic reactions, and emergence of resistant bacteria. The administration of antibiotic agents to prevent infection cannot be substituted for Surgical wounds may be designated as clean, contaminated, or dirty, […]

The golden rule of blood transfusion should be that no transfusion is given unless the benefit of the transfusion outweighs the risks. Before all blood transfusion,therefore,there must be a balance among the risks associated with the transfusion, the indications for transfusion, and the availability and benefit of using alternatives to conventional transfusion. The following is […]

  The HIV/AIDS disease in Kenya is currently affecting all age groups, including teens. It is important for the surgeon to appreciate the varying surgical presentations this disease has. Strict surgical barriers must be implemented at all times to avoid spreading of the disease between the patient and the surgeon. This can be achieved through […]

Theatre Etiquette In order to attain optimal results, a doctor operating in theatre is expected to maintain the following “rules”. Be involved in the preoperative selection and preparation of patients including obtaining of the informed consent. As the team leader, maintain strict time discipline and other aspects of good leadership. Be familiar with any problems […]